HomeMy WebLinkAbout12928Ultll11J11 ILIR I
CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 4AMED
21660 E. Copley Drive Suite 190
(909) 860-3195 Fax (909) 861-3117 l �R O 2002
BUILDING PERMIT APPLICATION l
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ISSUE TYPE OCC
JOSSITE
ZONING SETBACKS
ADDRESS�d
REAR ❑
SIDEISIDE STREET RW ❑
SIDE ❑
APN LOT �� TRACT 2q. f_e9
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OWNER
ADDRESS J�Y�(���� +►9.UC�"� e4 :
SFR/ADD/REM
APPLICANT TEL
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DESIGNER
ADDRESS
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CITY ZIP TEL
Valuation ADJ.AREA
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OUANTITY DESCRY ON FEE
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OWNER -BUILDER DECLARATION
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1 HERESY AFFIRM LINDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS L4
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CENSE UW FOR THE FOLLOWING REASON (SEC.7031.6 BUSINESS AND PROFESSIONS CODE: ANY CITY OR
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COUNTY WHICH REQUIRESAPERAUTTO CONSTRUCT,ALTER IMPROVE. DEMOLISH OR REPAIR ANYSTRUC-
TURE. PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED
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STATEMENT THAT HE OR SHE O LICENSED PURSUANT TO THE PROVISIONS OF THE CCNTRAC70RS U-
C
CENSE UW (CMPTER 6 (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PRO-
FESSIONS CODE)ORTHAT HEORSHE ISEXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP-
TON. ANY VIOLATION OF SECTION 7031.6 BYANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO
A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (11500)): .. -
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O LAS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION,
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WALL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, SUSI-
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WMANDPROFESSKINS COOS THE CONTRACTORS LICENSE UW DOES NOTAPPLY TO AN OWNER OF
PROPERTY WHO BULDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
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THROUGH ITIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR
OFFERED FOR SALE IF. 11OWEVERTHE BULDBKTORMPROVEMENT IS SOLE) WITHIN ONE YEAR OFCOMPLE-
• TION. THE OWNER-SUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
IMPROVE FOR THE PURPOSE OF SALE) :
O L AS OWNER OF THE PROPERTY. AM EXCLUSMELY CONTRACTING WITH LICENSED CONTRACTORS
TO CONSTRUCT THE PROJECT (SEG 7044. BUSINESS AND PIROFESSK)NS CODE: THE CONTRACTORS U-
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CENSE UW DOES NOT APPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON•AND
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WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S)LI TENSED PURSUANT TO THE CCNTRAC•
10RS UCENSE LAW ).
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O I AM EXEMPT UNDER SEC. D. l P.C. FOR THIS REASON
PRE -ALT FEE Cji'�f-onil+rP14 , BAR
13 CITY 3J �Y
DATE OWNER
TOTAL FEES 71
LICENSED CONTRACTORS DECLARATION
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Y
PERJURY THAT LICENSED UNDER OF CHAPTER
RECPT. NO. - PAID BY VALIDATION
I HEREBY AFFIRM UNDER PENALTY OF I AM PROVISIONS
S(OOAMENL7NG WITH SECTION 7000)OFDMSION 3 O THE BUSINESS AND PROFESSIONS CODE. AND
MY LICENSE IS N FULL FORCE AND EFFECT.
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LICENSE CLASS � .i �'9 LIC. NO.
DATe_/�' S 1 coNrnAcroR t
WORKERS' COMPENSATION DECLARATION
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I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
HAVE AND WILL MANTANA CERTIFICATE OF COISENTTO SELF -INSURE FOR WORKERS'
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COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE
OF 114E WORK FOR WHICH THIS PERMIT IS ISSUED.
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_ IHAVE AND WILL MAINTAIN WORKERS• COMPENSATION INSURANCE. AS REQUIRED BY SECTION
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3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED. MY WORKERS' COMPENSATION INSURANLCE CARRIER yp POLICY NUMSERARE:
CARRIER roe I rV
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POLICY HUMBER 6 7 ea J
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UMSEC)DNNEEDNOTSEMWLETWOF7WPEMUISMAaaM CRMWJARSR160)ORLESS)
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I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I
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SHALL NOT EM PLOY ANY PERSON N ANY MANNER SO AS TO BECOME SUBJECT TO THE
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WORKERS'COMPENSATON LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOUIDBEOOME
SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 of THE LABOR '
S
CODE. I SHALL FORTHWITH COMPLY WITH THOSE SONS.
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DATE: �/ - 7APPLICANI: !—�7 _
WARNING: FAILURE TO SECURE VKMERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL BE
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SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND
TO
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DOLLARS (3100,000) IN TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR N
c-
SEC TON 3708 OF THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBYAFFIRM UNDER PENALTY OF PERJURY THATTHERE IS ACONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC, 3037, CIV. Q)
LENDER'S NAME
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LENDER'SADORESS
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT.
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I AGR EE TO COMPLY WITH ALL CRY AND COUNTYOPDINANCES AND STATE LAWS RELATY40 TO BUILDING
CONSTRUCTION, AND HERE13YAUT/ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE.
AROVN/ENTIONED PROPERTY FOR INSPECTION PURPOSES.
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PE ITTEE (PRIH7)
SQ
NATURE OF PERMITTEE TE
PRESS
FIRMLY
APPLICATION PERMIT Q P!C
DATE NUMBERt7
ISSUE TYPE OCC
DATE 'CONST. GROUP
ZONING SETBACKS
FRONT RW ❑
REAR ❑
SIDEISIDE STREET RW ❑
SIDE ❑
PROPOSED USE
NO. DWEL. NO. NO.
UNITS STORIES BEDROOMS
DESCRIPTION SO. FT. FACTOR PSF ADJ.AREMALUATION
SFR/ADD/REM
Glirage/Carport
WPatio/Dock
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Re -Roof
Commercial -
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Valuation ADJ.AREA
OUANTITY DESCRY ON FEE
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QI 190
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CONSTRUCTION
PLAN REVIEW PAID
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MECHANICAL
INSPECTION FEE T 1 V ....1
IS AN IL.li 1 V • Op
SMIP
ENERGY P/C
ENERGY PERMIT
19 1999
RETENTION FEE: jAN
PRE -ALT FEE Cji'�f-onil+rP14 , BAR
13 CITY 3J �Y
TOTAL FEES 71
COMMENTS
RECPT. NO. - PAID BY VALIDATION
WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy GOLDENROD—Elle Copy, GREEN—Applicant's Copy V
CITY OF DIAMOND BAR • ;:; rl.
+�1 rr l' X' , ... INSPECTION RECORD':....
SET BACK I CFLOOR
JOIST.
-..;
FTGS/FORMS/STEEL
FHA REOMTS.-"- -.-...:
- - -
_ELECTRIC GROUND
UNDER FLOOR DUCT'
GROUND PLUMBING "'F' UNDER FLOOR CONDUIT
t �_
SLAB -GRADE - .. — -
FIREPLACE`FOUNDATION
` =
TEMP POWER - c' ` - - ' "' '
_' = FIREPLACE BOND BEAM
-WATER SERVICE - - _ - -_ _ -_ :::-
-_- _ - MID HT. BOND
ROOF SHEATHING—
-BEAM—::
8 FT.'BOND BEAM
- -
FRAMINGNENTILIATION
FINAL BOND BEAM
ROOF COVER .' ,
'PRE -GRADING
- - - -
-ROUGH HEATING -- -
-- - -BENCHING -
ROUGH ELECTRIC _i - ' - -
- = "'= -' ROUGH GRADING
ROUGH PLUMBING-! - - - "" `
FINISH GRADING,
SHOWER/TUB TEST - - ---- --_ --
POOL ELECTRIC
EXT. LATHISIDING- - _...
_.._ _. -POOL FENCING
WALL INSULATION
POOL FINAL _ =
CEILING INSULATION
OFF SITE IMPS.
DRYWALL NAILING
DEDICATIONS' ,
SEWER — - - -- - - -
- - FINAL ENG. .. .
_SEPTIC TANK _ _ _ _ _ _ _ _ .._
_ __ _ _ _ _LANDSCAPE/IRRIG.
SEEP PIT/L.L. T.= _=- _ _--- .- -
- ON SITE IMPS. .
GAS AIEi TEST; - -- - - --- —
- FINAL ZONING
FINAL CONST.,
FIRE DEPT. FINAL:'
FINAL HEATING ---" - :.
`', -HEALTH DEPT. FINAL
FINAL ELECTRIC-- ___ - '.
•"- �- �, - -DEV. FEES PAID
FINAL -PLUMBING
ENERGY -
-COMMENTS-
SEPTIC TANK SIZE
SEEP..PIT/U_SIZE_— -'----' = T;,VC w
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WASTEWATER
RECLAMATION
SOLID WASTE MANACEMEN
COUNTY SANITATION DISTRICTS
OF LOS ANGELES COUNTY
1955 Workman Mill Road, Whittier, CA 90601-1400
Mailing Address: P.O. Box 4998, Whittier, CA 90607-4998
Telephone: (562) 699-7411, FAX: (562) 699-5422
Counter Hours: 7:00 a.m. - 4:00 p.m. Mon. - Thurs.
7:00 a.m. - 3:00 p.m. Fri.
SEWERAGE SYSTEM CONNECTION FEE
Property Owner: DIAMOND BAR WEST LLC
Address of Property: 21887 GOLDEN CANYON COURT
DIAMOND BAR, CA 91765
Thomas Guide Page:
Contact:
KEN BAILEY
Phone:
909-396-5381
Mailing Address:
3480 TORRANCE BLVD STE 300
TORRRANCE, CA 90503
County Assessor Map Book, Page, and Parcel Number: 5713-021-006
Structure is Proposed.
User Category and Units of Usage:
Category:
01A
Number of Units:
1
Square Footage:
CONNECTION FEE CALCULATION
1.00 X $1,290.00
Number of Units of Usage Connection Fee Per Unit of Usage
COMMENTS:
BUILDI "EPT COPY
n v
J Recycled Paper
CHARLES W. CARRY
Chief Engineer and General Manager
.Account No . ' :0398431
District No 21
Date: December 29, 1998
$1,290.00
Connection Fee
$1,290.00
Connection Fee Due
7-7
trr.ne:a
f L 3 ANWiLL3 COU: vY
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VALID ONLY WHEN STANIPID
uODec 29 98 10:50a Citi of Diamond Bar 909-861-3117 p.1
' tj WALNUT VALLEY UNIFUD SCHOOL DISTRICT
ea 880 SOUTH LEMON AVENUE WALNUT CA 91789
CERTIFICATE OF COMPLIANCE
With Fee Provisions of
Government Code Section 65996
DEVELOPER/OWNERa Oene UST' LLL ,1V,r, J
ADDRESS YD. _ Signature of Applicant
CITY/ZIP The person signing represents that he/she is authorized
TELEPHONE ?,(b� 5 3ga�o to sign on behalf of the owner/developer and that the
information provided is true and accurate to the best of
his/her knowledge.
NEW LOT ADDRESS USE OF BUILDING TOTAL SQ. FT.
City
HOME IMPROVEMENT OR REMODELING PROJECT
ADDRESS DESCRIPTION TOTAL SQ. FT.
Diamond Bar Walnut (Bedroom, Family Rm., Kitchen, etc.)
Signature of Superintendent of Buildings Is Date 12-09-98
TO BE COMPLETED BY SCHOOL DISTRICT
FEE SCHEDULE: The development fees levied by the Walnut Valley Unified TOTAL FEES DUE
School District under provision of Government Code §65995 $ / r 1'
are: (EFF. 8/17/98) Residential Development 51:9�ls. ft Receipt It / 02.
Commercial/Industrial S . ft.Date /
Fees are assessed on TOTAL square footage "living space" of ALL new or remodeling construe on projects OVER 500 sq. feet
(eliminating garage or uncovered patio).
This is to certify that all fees due to the Walnut Valley Unified School District under provision of Government Code Section
65995 have been received and a building permit may be issued.
This is to certify that the above described development has been determined to be EXEMPT from the development fees of
Government Code Section 65995 and a building permit may be issued.
Exemption Justification: PROJECT IS 500.011 LESS SQUARE FEET
OTHER
Vernon Medeiros
Assistant Superintendent "
Fiscal and Facilities Management
1/87 Rev. 2/88; 6/88; 8189; 1/90; 8190; 10/90; 8192; 6/93; 11/93; 8/94; 6/96; 1/97; 8/98
PLEASE SEE NOTICE OF WDAY PERIOD FOR PROTEST OF FEES ON REVERSE SIDE
09/06/1999 .16:20, 9098640850 SITETECH INC PAGE 03
CITY OF DXA.MOND BAR
21660 ]? COPLEY DRIVE, SUITE 190
DIAMOND BAR. CA 91765.4177
(909)396.5671
SUPERVISED GRADING INSPECTION CERTIFICATE.
JOB ADDRESS/LOT AND TRACT N0. LOT 3, TRASZT 92850 PERMIT N0.
OWNER_ J.C.C- HOMES CONTRACTOR_ __
SOILS ENGINEER'S RO[JGH GRADING CEMFICAII
I certify that the earth fills pieced on the following lot(s) were installed upon competent and property prepared base material and
compacted in compliance with requirements of Building Code Section 3317. 1 further certify that where the report or reports of
engineering geologist, relative to this site, have recommended the installation of buttresses, fills or other similar stabilization
measures, such earthwork construction has been completed in accordance with the approved design.
LOTNO.(S)
See report dated for compaction test data, recommended allowable soil bearing values and other
recommendations.
EXPANSIVE SOILS (YES) (NO) LOT NO. (S)
BUTTRESS FILLS (YES) (NO) LOT NO. (S)
REMARKS
ENGINEER REG. NO. DAZE
Signature (and wet -stamp)
NUPERMING GRADING ENGINEER'S ROUGH GRADING CERTIFICA ON
I certify to the satisfactory completion of rough grading including: grading to approximate final elevations, property lines located
and staked; cut and fill slopes correctly graded and located in accordance with the approved design; swales and terraces traded
ready for paving, barns installed; and required drainage slopes provided on the building pads_ I further certify that where report
or reports ofd an engineering geologist and/or sails wgineer have been prepared relative to this site, the recommendations
contained in soils reports have been followed in the execution of the work
LOTNO.(S)
REMARKS
ENGINEER REG. NO. DATE
Signature (and wet -stamp)
SUPERVISING GRADING ENGINEER'S FINALS GRADING CEWMFICATION
I certify to the satisfactory completion of grading in accordance with the approved pians. All required drainage devices have been
installed; slope planting established and irrigation systems ,provided (where required); and adequate provisions have been made
for drainage of surface waters from each building site. The recommendations of the soils engineer and engineering geologist (if
such persons were aaployed) have been incorporated in the work.
LOTNO.(S) LOT 3. TRACT 4785n
REMARKS SOILS ENGINEERINg
ENGINEER REG.NO. B.C.E. 36866 DATE 9-8-99
d wet -stamp)
Sjgt
GRADING CERMCA77ON BY 7HE SOILS ENGINEER AND GRADING ENGINEER IS REQ?
GRADE INSPEC770N AND W.FASE 70 BUILDING DEPARTMENT FOR SIRUt+TURAL PERAM
FINAL GRADING CFA 77FIt:A770NBYTHE GRADING ENGINEER IS REQUIRED BEFORE FINAL
AND RELEASE 7D BUILDING DEPAR7MENT,FOR 0CCUPANCYOFS7RUC7VRE